IN FACIAL palsy due to operative trauma or to fracture of the temporal bone, the nerve may be completely torn across and the patient will never recover facial movements unless nerve grafting is performed. In other cases of facial palsy the nerve looks perfectly healthy, and in these the palsy is probably due to an interference with the blood supply of the nerve. Most of these palsies will clear up spontaneously but some may not.
If the blood supply to the facial nerve is interrupted an ischemic facial palsy follows. If the circulation is blocked for a prolonged period the neural tissue will degenerate and extraneural and intraneural scar tissue will develop. In this case the conductive power will be just as effectively destroyed as if the nerve had been cut. The degree and the duration of the impairment of circulation determines the pathological processes which arise in and around
KETTEL K. Degeneration of the Facial Nerve: Nerve Transformed Into Connective Tissue in Chronic Cholesteatomatous Otitis Media. Arch Otolaryngol. 1966;83(6):517–519. doi:10.1001/archotol.1966.00760020519005
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